Impact of Loading and Myocardial Mechanical Properties on Natural Shear Waves: Comparison to Pressure-Volume Loops

Stéphanie Bézy, Jürgen Duchenne, Marta Orlowska, Annette Caenen, Matthew Amoni, Sebastian Ingelaere, Laurine Wouters, Keir McCutcheon, Lennert Minten, Alexis Puvrez, Jan D'hooge, Jens Uwe Voigt*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)


Background: Shear wave elastography (SWE) has been proposed as a novel noninvasive method for the assessment of myocardial stiffness, a relevant determinant of diastolic function. It is based on tracking the propagation of shear waves, induced, for instance, by mitral valve closure (MVC), in the myocardium. The speed of propagation is directly related to myocardial stiffness, which is defined by the local slope of the nonlinear stress-strain relation. Therefore, the operating myocardial stiffness can be altered by both changes in loading and myocardial mechanical properties. Objectives: This study sought to evaluate the capability of SWE to quantify myocardial stiffness changes in vivo by varying loading and myocardial tissue properties and to compare SWE against pressure-volume loop analysis, a gold standard reference method. Methods: In 15 pigs, conventional and high–frame rate echocardiographic data sets were acquired simultaneously with pressure-volume loop data after acutely changing preload and afterload and after inducting an ischemia/reperfusion (I/R) injury. Results: Shear wave speed after MVC significantly increased by augmenting preload and afterload (3.2 ± 0.8 m/s vs 4.6 ± 1.2 m/s and 4.6 ± 1.0 m/s, respectively; P = 0.001). Preload reduction had no significant effect on shear wave speed compared to baseline (P = 0.118). I/R injury resulted in significantly higher shear wave speed after MVC (6.1 ± 1.2 m/s; P < 0.001). Shear wave speed after MVC had a strong correlation with the chamber stiffness constant β (r = 0.63; P < 0.001) and operating chamber stiffness dP/dV before induction of an I/R injury (r = 0.78; P < 0.001) and after (r = 0.83; P < 0.001). Conclusions: Shear wave speed after MVC was influenced by both acute changes in loading and myocardial mechanical properties, reflecting changes in operating myocardial stiffness, and was strongly related to chamber stiffness, invasively derived by pressure-volume loop analysis. SWE provides a novel noninvasive method for the assessment of left ventricular myocardial properties.

Original languageEnglish
Pages (from-to)2023-2034
Number of pages12
JournalJACC: Cardiovascular Imaging
Issue number12
Publication statusE-pub ahead of print - 14 Sep 2022

Bibliographical note

This work is supported by a Research Foundation–Flanders (FWO)
project grant (G092318N). Dr Voigt is supported as a senior clinical
investigator by the FWO (1832917N). Drs Duchenne and Caenen are
supported by an FWO project grant (T002919N and 1211620N). All
other authors have reported that they have no relationships relevant
to the contents of this paper to disclose.

Publisher Copyright:
© 2022 American College of Cardiology Foundation


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